An uncommon presentation of cryptorchidism

Cryptorchidism as a cause of bowel obstruction is very unsuspecting. Bowel obstructions in cases of cryptorchidism, though reported were mostly as a complication of malignant transformation. Only two case reports of cryptorchidism document a non-malignant aetiology for bowel obstruction. This case is of a 16 year old boy referred for pain abdomen and obstipation for last 3 days. He had signs of peritonitis on examination and so, urgent exploratory laparotomy was planned. A loop of jejunum of approx. 30 cm length at a distance of 35 cm from duodeno-jejunal junction was found gangrenous with gubernacular bands around the loop emerging from a left cryptorchid testis. Resection– anastomosis was done along with left orchidectomy. Histopathology revealed an atrophied testis with no malignant changes. This is the first case report of a non-malignant cryptorchid testis as a cause of strangulated intestinal obstruction in literature.

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Proteus syndrome in pregnancy: A case report

Obstetric Medicine ◽

10.1177/1753495x20970791 ◽

2020 ◽

pp. 1753495X2097079

Author(s):

Niccole Ranaei-Zamani ◽

Mandeep K Kaler ◽

Rehan Khan

Keyword(s):

Case Report ◽

Case Reports ◽

Proteus Syndrome ◽

Cutaneous Lesions ◽

Genetic Syndrome ◽

Skeletal Tissue ◽

First Case ◽

Large Teaching Hospital ◽

Clinical Presentations ◽

In Pregnancy

Proteus syndrome is a rare, multi-system, genetic syndrome characterised by atypical and excessive growth of skeletal tissue. Clinical presentations include abnormal musculoskeletal growth and cutaneous lesions. Due to its rarity, there have been a limited number of published case reports of Proteus syndrome. This is the first case report on the management of Proteus syndrome in pregnancy. We present the case of a pregnant woman with Proteus syndrome in her first pregnancy in a large teaching hospital and discuss the considerations and challenges faced in her antenatal, intrapartum and postnatal care.

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Intraperitoneal ampicillin treatment for peritoneal dialysis- related peritonitis with Listeria monocytogenes – a case report

BMC Nephrology ◽

10.1186/s12882-020-02068-1 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Kristina Boss ◽

Ina Wiegard-Szramek ◽

Jan Dziobaka ◽

Andreas Kribben ◽

Sebastian Dolff

Keyword(s):

Peritoneal Dialysis ◽

Case Report ◽

Listeria Monocytogenes ◽

Case Reports ◽

Chronic Kidney Disease Stage ◽

Disease Stage ◽

Serum Concentrations ◽

Duration Of Treatment ◽

First Case ◽

Listeria Infection

Abstract Background Peritoneal dialysis (PD)-related peritonitis is a rare but serious complication and is associated with increased morbidity and mortality rates. It is most commonly caused by Staphylococcus aureus or Staphylococcus epidermidis, but infection with Listeria monocytogenes may also occur. Recommendations for antibiotic treatment of a Listeria infection are currently based on a small number of case reports and suggest the administration of ampicillin. But unlike vancomycin or gentamicin, for ampicillin the route of application, the dosage, and the duration of treatment have not yet been established. We report a case in which PD-associated peritonitis due to Listeria infection was treated with ampicillin administered intravenously and intraperitoneally, separately and in combination. Case presentation A 72-year-old man with chronic kidney disease stage 5 dialysis (CKDG5D) secondary to hypertension and diabetes was hospitalised in April 2020 because of PD-related peritonitis caused by a Listeria infection. In accordance with the results of resistance tests, the patient was treated with intravenous ampicillin at a dosage of 6 g twice daily. After initial treatment the leukocyte count in the PD effluent had decreased substantially, but it was permanently reduced only with the addition of intraperitoneal ampicillin (4 g daily). Efficient serum concentrations of ampicillin were determined for both routes of administration, intravenous and intraperitoneal. Conclusion This is the first case report demonstrating that PD-related peritonitis due to Listeria monocytogenes infection can be treated with intraperitoneal ampicillin and monitored by the determination of peripheral serum concentrations of ampicillin.

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Myelopathy in sickle cell disease: a case-oriented review

10.5327/1516-3180.563 ◽

2021 ◽

Author(s):

Igor Vilela Brum ◽

Guilherme Diogo Silva ◽

Diego Sant'Ana Sodre ◽

Felipe Melo Nogueira ◽

Samira Luisa dos Apostolos Pereira ◽

...

Keyword(s):

Spinal Cord ◽

Case Report ◽

Sickle Cell Disease ◽

Sickle Cell ◽

Case Reports ◽

Spinal Cord Infarction ◽

Sensory Level ◽

Cell Disease ◽

Hematopoietic Tissue ◽

First Case

Background: Although neurological complications are well recognized in sickle cell disease (SCD), myelopathy has been rarely described. We present the first case report of longitudinally extensive myelitis (LETM) in SCD and review the differential diagnosis of myelopathy in these patients. Design and setting: case-oriented review. Methods: We report the case of a 29-year-old African-Brazilian man with SCD, who experienced a subacute flaccid paraparesis, with T2 sensory level and urinary retention. CSF analysis showed a lymphocytic pleocytosis and increased protein levels. MRI disclosed a longitudinally extensive spinal cord lesion, with a high T2/STIR signal extending from C2 to T12. Serum anti-aquaporin-4 antibody was negative. We searched Medline/ PubMed, Embase, Scopus, and Google Scholar databases for myelopathy in SCD patients. Results: Spinal cord compression by vertebral fractures, extramedullary hematopoietic tissue, and Salmonella epidural abscess have been reported in SCD. We found only three case reports of spinal cord infarction, which is unexpectedly infrequent compared to the prevalence of cerebral infarction in SCD. We found only one case report of varicella-zoster myelitis and no previous report of LETM in SCD patients. Conclusion: Specific and time-sensitive causes of myelopathy should be considered in SCD patients. In addition to compression and ischemia, LETM should be considered as a possible mechanism of spinal cord involvement in SCD.

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Small Bowel Obstruction by Broad Ligament Hernia: Three Case Reports, Management and Outcomes

Acta Médica Portuguesa ◽

10.20344/amp.10951 ◽

2019 ◽

Vol 32 (3) ◽

pp. 240

Author(s):

Manuela Graça Fernandes ◽

Ana Rita Mateus Loureiro ◽

Maria João Diogo Obrist ◽

César Prudente

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Case Reports ◽

Broad Ligament ◽

Exploratory Laparotomy ◽

Anatomical Location ◽

Internal Hernias ◽

Surgical History ◽

Broad Ligament Defect

Internal hernias are a rare cause of bowel obstruction (1%) and can be caused by broad ligament defects in 4% to 7% of the cases. These defects may be congenital or acquired and are classified according to its anatomical location. This paper reports three cases of small bowel obstruction by broad ligament hernia. The patients, three women aged from 35 to 51 years old, were admitted to the emergency department with small bowel obstruction. An exploratory laparotomy was performed during which an internal hernia through a broad ligament defect was identified. In all cases the hernia content was reduced and the defect closed. One of the patients required a segmental enterectomy. All patients had a favorable outcome. This paper aims to raise awareness about the broad ligament hernia as a cause of bowel obstruction, namely in middle-aged women with no surgical history.

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Metastatic Pancreatic Cancer with BRAF and P53 Mutations: Case Report of Therapeutic Response to Doublet Targeted Therapy

Case Reports in Oncology ◽

10.1159/000510096 ◽

2020 ◽

Vol 13 (3) ◽

pp. 1239-1243

Author(s):

Shenthol Sasankan ◽

Lorraine Rebuck ◽

Gloria Darrah ◽

Moises Harari Turquie ◽

Ian Rabinowitz

Keyword(s):

Pancreatic Cancer ◽

Case Report ◽

Targeted Therapy ◽

Therapeutic Response ◽

Case Reports ◽

Clinical History ◽

P53 Mutation ◽

Metastatic Pancreatic Cancer ◽

First Case ◽

History Of

We report on the clinical history of a 49-year-old female with metastatic pancreatic cancer. She was initially treated with standard chemotherapy as per current guidelines. She was found to have both a BRAF and P53 mutation, and received dabrafenib and trametinib with deep responses, both radiographically and biochemically (CA19-9). Her response has been more clinically relevant than responses in previous case reports of patients with BRAF-positive pancreatic cancer treated with targeted therapy. To the best of our knowledge, this is the first case report showing a dramatic therapeutic response to combination therapy with dabrafenib and trametinib in metastatic pancreatic cancer.

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Ileosigmoid knotting: an unusual cause of acute intestinal obstruction with bowel gangrene

BMJ Case Reports ◽

10.1136/bcr-2018-226663 ◽

2019 ◽

Vol 12 (5) ◽

pp. e226663

Author(s):

Raj Kumar ◽

Pavan Kumar Shamanur Kenchappa ◽

Kusum Meena ◽

Brijesh Kumar Singh

Keyword(s):

Intestinal Obstruction ◽

Sigmoid Colon ◽

Bowel Obstruction ◽

Exploratory Laparotomy ◽

Large Bowel Obstruction ◽

Acute Intestinal Obstruction ◽

Haemodynamic Instability ◽

Ileocolic Anastomosis ◽

Bowel Gangrene

Ileosigmoid knotting (ISK) is a rare cause of intestinal obstruction rapidly progressing to bowel gangrene. It is characterised by the wrapping of loops of ileum and sigmoid colon around each other. The condition often remains undiagnosed preoperatively; however, it can be suspected by the triad of small bowel obstruction, radiographic features suggestive of predominately large bowel obstruction and inability to deflate the intestine by a sigmoidoscope. We are reporting a case of 56-year-old man who presented with features of acute intestinal obstruction and compensated shock within 24 hours of onset of symptoms. Exploratory laparotomy revealed ISK resulting in gangrene of ileum and sigmoid colon. In view of haemodynamic instability, end ileostomy was done after excising gangrenous segments. The patient improved and stoma closure and ileocolic anastomosis were done after 3 months in follow-up.

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First case report of infection by Mycobacterium wolinskyi after mammoplasty in Brazil

Infectious Disease Reports ◽

10.4081/idr.2013.e12 ◽

2013 ◽

Vol 5 (2) ◽

pp. 12 ◽

Cited By ~ 3

Author(s):

Andrea Santos Lima ◽

Maria Madileuza Carneiro Neves ◽

Karen Machado Gomes ◽

Klarissa Miranda Guarines ◽

Carlos Feitosa Luna ◽

...

Keyword(s):

Case Report ◽

Health Service ◽

Mycobacterium Smegmatis ◽

Case Reports ◽

Specific Gene ◽

Biochemical Tests ◽

Long Period ◽

First Case ◽

The World ◽

Mycobacterium Goodii

Mycobacterium wolinskyi is a rapidly growing mycobacterium, first described in 1999 as a member of the group Mycobacterium smegmatis (Mycobacterium smegmatis, Mycobacterium wolinskyi and Mycobacterium goodii). Only 19 case reports all over the world have been described on literature, none of them in Brazil. On this report, it is described one case of infection after a mammoplasty procedure performed in a private health service in the county of Recife, Pernambuco, Brazil, in 2009. The mycobacteria specie was identified using biochemical tests and sequencing the specific gene rpoB. To treat the infection by Mycobacterium wolinskyi it was necessary to combine antibiotics for a long period of time associated with surgical procedures of the breast abscesses.

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Burning Mouth Syndrome: Problem in the Mouth?

European Psychiatry ◽

10.1016/j.eurpsy.2017.02.049 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S254-S254

Author(s):

S. Petrykiv ◽

L. de Jonge ◽

M. Arts

Keyword(s):

Case Report ◽

Case Reports ◽

Antidepressant Medication ◽

Burning Mouth Syndrome ◽

Psychiatric Ward ◽

Drug Induced ◽

First Case ◽

Painful Sensation ◽

Burning Mouth ◽

Competing Interest

IntroductionBurning mouth syndrome (BMS) is characterized by an intraoral burning sensation for which no medical or dental cause can be found. Sporadic evidence suggests that drug induced conditions may evoke BMS. Intriguingly, we observed a patient who developed BMS after induction of citalopram.Objectives & aimsA case report of patient with BMS from our psychiatric ward will be presented here, followed by a literature review on drugs induced BMS.MethodsBased on a recent literature search, we present a first case report of BMS that was apparently induced in patient shortly after beginning of citalopram. We performed a systematic search through PubMed, EMBASE and Cochrane's Library to find more cases of psychotropic induced BMS.ResultsMs. A. was a 72-year old woman meeting DSM-IV diagnostic criteria for melancholic depression, who was observed in a clinical setting. We started citalopram 10 mg. 1dd1, with 10 mg. 1dd1 increase over 7 days to 20 mg, 1dd1. The following day, she displayed a persistent burning painful sensation in the mouth. Other than BMS oropharyngological syndromes were excluded after consultation with qualified medical specialists. Citalopram therapy was discontinued, and nortrilen treatment was initiated. BMS symptoms resolved over four days. Twelve case reports have linked BMS to the use antidepressants and anxiolytics.ConclusionContrasting the statement that no medical cause can be found for BMS, we found that psychotropics may evoke the syndrome. Compared to other psychotropic drugs, antidepressant medication has the strongest association with BMS.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Citalopram–induced delusions in an older adult

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1399 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S751-S752

Author(s):

J. Fennema ◽

S. Petrykiv ◽

L. De Jonge ◽

M. Arts

Keyword(s):

Case Report ◽

Older Adult ◽

Selective Serotonin Reuptake Inhibitors ◽

Case Reports ◽

Dose Range ◽

Early Morning ◽

Medical Evidence ◽

First Case ◽

Therapeutic Dose Range ◽

Competing Interest

IntroductionSelective serotonin reuptake inhibitors (SSRIs) are the most prescribed antidepressants worldwide. In older adults, citalopram is generally well tolerated and safe in the therapeutic dose range of 20 to 40 mg/day. In literature, there are cases of SSRI-induced psychosis, but mainly with fluoxetine. There are only three reported cases of citalopram-induced delusions, however, these case-reports did not involve an older adult.Objectives and aimsTo provide a case of citalopram–induced psychosis in an older adult, followed by the review of available literature.MethodsA case report is presented and discussed followed by a literature review.ResultsA 64-year-old woman without somatic illnesses was referred by a general practitioner with depressive symptoms. One week after initiation of citalopram 10 mg/day she suddenly developed delusions, predominantly in the early morning. No other medical evidence was found that could explain her delusions. After discontinuation of citalopram her delusions quickly resolved.ConclusionThis is the first case report of a SSRI-induced delusion in an older adult. Citalopram has been reported to be one of the safest SSRIs. Although most SSRI's have a mild side-effect profile, care should be taken when initiating SSRIs since unpredictable adverse effects may occur.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Gallstone Ileus: A Case Report

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2020.4657 ◽

2020 ◽

Vol 8 (C) ◽

pp. 121-124

Author(s):

Darmadi Darmadi ◽

Riska Habriel Ruslie ◽

Carolus Trianda Samosir

Keyword(s):

Case Report ◽

Mortality Rate ◽

Bowel Obstruction ◽

High Mortality ◽

Medical Condition ◽

Gallstone Ileus ◽

Exploratory Laparotomy ◽

Water Soluble ◽

Intestinal Lumen ◽

Female Population

BACKGROUND: Gallstone ileus (GI) is a mechanical obstruction in the intestinal lumen due to gallstones. Its prevalence is very low, but it possesses a high mortality rate. It is commonly found in older female population. CASE REPORT: We reported a case of GI in a 61-year-old Chinese female, who presented with acute onset of abdominal pain, nausea, and intermittent vomiting. On water-soluble contrast follow-through examination, she showed total bowel obstruction on the level of terminal ileum due to suspected gallstone. Exploratory laparotomy with procedure of enterolithotomy and stone removal by milking the bowel distal to the stone were performed. Post-operative course was uneventful, but the patient was discharged at post-operative day 8. Furthermore, the patient underwent cholecystectomy and fistula repair in the following days (two-stage surgery). She was followed up in the clinic for 12 months and the patient remained asymptomatic. CONCLUSION: GI is a rare medical condition with a high mortality rate, commonly affecting females and elder population. It must be considered in a patient with bowel obstruction, especially with a history of cholelithiasis. Many clinicians prefer enterolithotomy alone, followed by cholecystectomy at later date, because of its lower morbidity and report high spontaneous fistula closure.

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